Pharmacy QA & Compliance Analyst — CMS/NCQA Audits

Zing Health, Inc.; Illinois; Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Flexible scheduling

Job summary

Zing Health is seeking a detail-oriented Pharmacy Quality Assurance Analyst to ensure operations meet CMS and NCQA standards. The role emphasizes compliance, process improvements, internal and external audits, and coordination with vendor and marketing quality controls.

The ideal candidate will have strong analytical skills, knowledge of SQL queries, and experience with PBM reporting. Bilingual English/Spanish is preferred, with flexible scheduling as needed.

Qualifications

• Preferred: Registered Pharmacy Technician and Certification.
• Education: Bachelor’s degree or 5+ years of healthcare experience.
• Experience with CMS/NCQA audits and QA processes is expected.
• SQL data queries and report generation experience is a plus.

Responsibilities

• Evaluate policies against CMS/NCQA requirements; identify gaps and improvements.
• Lead audits of pharmacy operations and ensure corrective actions.
• Reconcile vendor invoices and resolve member/provider issues.
• Oversee monthly quality checks for marketing materials.
• Support CMS/NCQA audits and maintain audit samples and logs.
• Provide training on CMS/NCQA requirements and administer exams.

Skills

Analytical skills

SQL queries

Communication skills

Bilingual (English/Spanish)

PBM reports

BI analysis

Project management

Teamwork

Modeling/OOA

Flexible schedule

Education

Bachelor's degree or 5+ years healthcare experience

Job description

Zing Health is seeking a detail-oriented Pharmacy Quality Assurance Analyst to ensure operations meet CMS and NCQA standards. The role emphasizes compliance, process improvements, internal and external audits, and coordination with vendor and marketing quality controls.

The ideal candidate will have strong analytical skills, knowledge of SQL queries, and experience with PBM reporting. Bilingual English/Spanish is preferred, with flexible scheduling as needed.